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. 2013 Jun;15(6):1122-9.
doi: 10.1093/ntr/nts252. Epub 2012 Nov 22.

Predictors of lapse in first week of smoking abstinence in PTSD and non-PTSD smokers

Jean C Beckham  1 , Patrick S Calhoun, Michelle F Dennis, Sarah M Wilson, Eric A Dedert
Affiliations

Predictors of lapse in first week of smoking abstinence in PTSD and non-PTSD smokers

Jean C Beckham et al. Nicotine Tob Res. 2013 Jun.

Abstract

Introduction: Retrospective research suggests smokers with posttraumatic stress disorder (PTSD) lapse more quickly after their quit date. Ecological momentary assessment (EMA) research is needed to confirm the presence of early smoking lapse in PTSD and form conceptualizations that inform intervention.

Methods: Smokers with (n = 55) and without (n = 52) PTSD completed alarm-prompted EMA of situational and psychiatric variables the week before and after a quit date, and self-initiated EMA following smoking lapses. Blood samples at baseline and on the quit date allowed assessment of dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEA(S)).

Results: PTSD was related to shorter time to lapse (hazard ratio [HR] = 1.677, 95% CI: 1.106-2.544). Increased smoking abstinence self-efficacy was related to longer time to lapse (HR = 0.608, 95% CI: 0.430-0.860). Analyses of participants' real-time reports revealed that smokers with PTSD were more likely to attribute first-time lapses to negative affect ( = 5.412, p = .020), and trauma reminders (Fisher's exact p = .003**). Finally, the quit date decrease in DHEA(S) was related to shorter time to lapse (HR = 1.009, 95% CI: 1.000-1.018, p < .05).

Conclusions: Results provide evidence of shorter time to first smoking lapse in PTSD, and add to evidence that early lapse occasions are more strongly related to trauma reminders, negative affect, and cravings in smokers with PTSD.

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Figures

Figure 1.
Figure 1.
Model of posttraumatic stress disorder (PTSD) and smoking onset and maintenance.
Figure 2.
Figure 2.
Survival curves for smoking lapse in posttraumatic stress disorder (PTSD) versus non-PTSD in first week of a quit attempt.
See this image and copyright information in PMC

References

    1. American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders, (4th ed.). Washington, DC: Author;
    1. Bandura A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191–215 - PubMed
    1. Bandura A. (1997). Health promotion from the perspective of social cognitive theory. Psychology and Health, 13, 191–215
    1. Baron J. A., Comi R. J., Cryns V., Brinck-Johnsen T., Mercer N. G. (1995). The effect of cigarette smoking on adrenal cortical hormones. Journal of Pharmacology and Experimental Therapeutics, 272, 151–155 - PubMed
    1. Beckham J. C., Dennis M. F., McClernon F. J., Mozley S. L., Collie C. F., Vrana S. R. (2007). The effects of cigarette smoking on script-driven imagery in smokers with and without posttraumatic stress disorder. Addictive Behaviors, 32, 2900–2915 - PMC - PubMed

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